The impact of elevated posttraumatic stress on the efficacy of brief alcohol interventions for heavy drinking college students

Abstract

Brief alcohol interventions (BAIs) have been widely adopted for use with college students and are associated with significant reductions in drinking and problems. However, many students do not respond to these approaches and little is known about risk factors for poor response. The current study investigated one possible risk factor by examining the impact of posttraumatic stress (PTS) symptoms on BAI efficacy. This study presents pooled data from two randomized clinical trials © 2012 Elsevier Ltd. All rights reserved. Contributors: Authors Christopher Monahan, Meghan McDevitt-Murphy and James Murphy contributed to the conceptualization, design, and literature review of this research study. All authors assisted with the statistical analysis and provided substantial feedback on all manuscript drafts. All authors contributed to and have approved the final manuscript. Conflict of interest: No conflict declared.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Follow-up assessments were completed six months post-intervention. Analyses testing differences in frequency of past-month heavy episodic drinking revealed a significant post-traumatic stress by time interaction (F(1,165) = 8.27, p = .005) such that individuals screening positive for PTS showed larger reductions in heavy episodic drinking at follow-up. A significant three-way interaction between time, PTS, and intervention condition (F(2,167) = 5.76, p = .004) was found for alcohol related consequences. Specifically, among individuals screening positive for PTS, only those that received the counselor-administered BAI showed a significant reduction in consequences at follow-up. These results suggest that overall college students with PTS may respond well to BAIs and that counselor-delivered BAIs may be more efficacious than computerdelivered interventions for reducing alcohol problems for these high-risk students. NIH Public Access

Episode-Specific Drinking-to-Cope Motivation, Daily Mood, and Fatigue-Related Symptoms Among College Students

“…One possibility is that depressed students are more likely to demonstrate these processes, which, in turn, serve to maintain such symptoms (i.e., high negative affect and fatigue). Counselor-administered interventions that can be tailored to also focus on coping skills and motives for drinking relevant to life stress and depressed mood might be most effi cacious in treating college students displaying such characteristics (e.g., Monahan et al, 2013).…”

Electronic Interventions for Alcohol Misuse and Alcohol Use Disorders

“…In 5 trials rated as low to moderate risk of bias in students (37,48,49,52), e-interventions resulted in no statistically significant reduction in binge drinking (MD, −0.1 episodes [CI, −0.6 to 0.4]) at 6-month follow-up. Effect sizes had moderate heterogeneity (Q = 8.8; P = 0.066; I 2 = 55%); 1 trial rated as low risk of bias that studied human support reported significant effects (44).…”

Social network influences on initiation and maintenance of reduced drinking among college students.

“…That is, counselor-delivered interventions may be particularly efficacious relative to computer-delivered interventions among individuals with riskier social networks. Efficacy of counselor- versus computer-delivered interventions varies as a function of individual differences at both short-term follow-ups (i.e., 1-3 months; Carey, Henson, Carey, & Maisto, 2009; Donohue et al, 2004; Mastroleo, Murphy, Colby, Monti, & Barnett, 2011) and longer-term follow-ups (i.e., beyond 3 months; Monahan et al, 2013). Social network attributes may therefore moderate intervention efficacy in the context of both initiation and maintenance of change.…”